War and Medicine

My colleagues suggested that we spent our Thursday afternoon visiting an exhibition entitled “War and Medicine” at the Wellcome Collection in Euston, London. I had not heard anything about it apart from the occasional spotting of posters in tube stations, but I immediately accepted the invitation. I never got the opportunity to visit the Wellcome collection and another friend had already told me that it houses interesting items in their permanent collection. I consented to the visit even though I knew that we would not have time to visit the permanent collection. Besides, what else can you do during a cold Thursday evening?

The exhibition, organised by the Welcome Collection in collaboration with the Deutches Hygiene Museum in Dresden, turned out to be very interesting, although some of my colleagues found some exhibits disturbing and, in some ways, stomach churning. It inteded to illustrate the outcome of medical practices and research during armed conflicts and in the aftermath of war. It focuses in the Crimean War and the two World Wars, but there are also items from more recent conflicts. The gallery guide says:

“Those charged with the treatment and care of the casualties of war can expect to be confronted with a bewildering range of stark choices and ethical dilemmas. As we have developed increasingly sophisticated weaponry with which to harm our enemies, medicine has had to adapt quickly to cope with the volume and the changing nature of the resulting casualties. Medical scientists have learned valuable lessons and made vital discoveries in times of war, but they have also been party to some of war’s worst acts of inhumanity”.

The exhibition was divided into three thematic areas: the organisation, the body and the mind. We were first introduced to organisational changes during war, with a special focus on sanitation, food, clothing, accommodation and medical care. The dominating section, the body, concentrated on the effects of war on the human body. From the information leaflets issued during the wars to educate soldiers on proper body hygiene and avoidance of deadly diseases, we embarked on a journey to the consequences of war to the individual, ranging from diseases, injury and death to plastic surgery, rehabilitation and prosthesis. However, it is not only the physical burden that a war imparts to the individual but the ensuing emotional toll. The final section, the mind, although limited in magnitude, highlighted the invisible scars that war creates, with a special focus on post-traumatic stress disorder.

The "Diagram of the causes of mortality in the army in the East" was published in Notes on Matters Affecting the Health, Efficiency, and Hospital Administration of the British Army and sent to Queen Victoria in 1858. The copyright of this image has expired (source Wikipedia).

In the beginning of the body section, I spotted an interesting informational leaflet given to the American soldiers serving in the tropics with the purpose to inform about the dangers of malaria and its transmission via mosquito bites. “This is Ann. She’s dying to meet you” was the title of this aptly illustrated book by Dr Seuss that encouraged safe practice to avoid bites from Anopheles mosquitoes. Equally interesting was a diagram by Florence Nightingale on the “causes of mortality in the army in the East” during the Crimean war, illustrating that the majority of fatalities were the cause of disease. I was left in jaw-dropping awe, not for realising that disease killed more people than war, but for the ability of Florence to make such a visually appealing graph that Edward Tufte would be very fond of. In the body section, there was also a copy of the Esmarch bandage, a triangular shaped fabric with illustrations of 32 different ways it can be folded to treat wounds and stop bleeding.

Perhaps the single most interest item was the explanation of the triage system; a system for the rapid medical assessment of wounded individuals who require urgent attention. We were informed that this was pioneered by Nikolai Pirogov and Dominique Jean Larry. Today, the modern medical triage system classifies patients into four different categories: i) immediate (priority 1 – red color), those that have a life threatening injury, ii) urgent (priority 2 – yellow color), those that have serious but non life-threatening injury iii) delayed (priority 3 – green color), who are walking wounded and iv) dead or morgue (black color –self explanatory). Interestingly, the criteria for the triage system assess whether the patient is able to walk, to breathe and whether he/she has specific rates of respiration. But in certain circumstances, a reverse triage system is in place:

“It should also be remembered that when the warfare is at its most intense, the most significant motivation behind the medical attention given to an individual soldier may be the need to return him to the front line as quickly as possible”.

The exhibition concludes with a note of optimism among the brutalities and the raw images that the visitor has experienced. Anthropologist Catherine-Panther Brick conducted the first systematic, large-scale, qualitative study of children aged 11-16 old to assess their mental health during war. In her study, she asked children to make drawings of how they find themselves now and in the future. Most drawings show children that appear unhappy and crying but looking into the future, the drawings reveal a remarkable degree of optimism and striking level of ambition.

Lambda.

P.S.: Regretfully, the exhibition has now ended, but you can still visit the online resources and especially the image galleries.